Over the last 18 months, many of us have had the experience of seeing a doctor by video. Certain health problems we thought never could have been solved by a telemedicine visit were simply and easily managed with the touch of a button.
For people who seek integrative and functional medicine care, many of us have been wondering: should I receive my care virtually, even when I don’t “have to”?
What is telemedicine, exactly?
Generally speaking, a telemedicine visit is defined by seeing a clinician (usually a doctor, but also nurse practitioners, physician assistants, psychologists, and other health practitioners are included) via a computer, smart phone, or similar electronic device. In some states, a telemedicine visit can also be defined by having a consultation by phone without video images. Some chat visits via texting may also apply.
Telemedicine has been around for decades, but use has dramatically increased over the last couple of years, mostly because of COVID-19. It is estimated that as of this writing, there has been a 38x increase in telemedicine visits from April, 2020.
Is it safe to receive care via a telemedicine visit?
It is estimated that approximately 70% of all medical conditions can be managed by telemedicine visits.
While it is pretty obvious that certain health problems do not lend themselves well to a telemedicine visit (traumatic injuries and surgeries, for example), many conditions are quite safely managed via video.
So, conditions are able to be managed via telemedicine, but is it safe? Let me explain.
Doctors of all types are trained to listen to the patient and ask probing questions. The adage in medicine is that 90% of the diagnosis comes from the patient’s story. If your story raises concern about something that can’t be effectively evaluated via video, the clinician can send you for additional testing or for an in-person evaluation. In that way, your clinician always has an ear tuned for “red flags” and the need for further evaluation.
That said, many health issues lend themselves perfectly to a telemedicine approach. Diagnosis and management of hormone imbalance, thyroid conditions, gut health problems, mild depression and anxiety, fertility issues, food sensitivities, and even some more chronic issues like Lyme Disease can be managed via telemedicine.
Conversely, health problems that are quite severe and that require routine monitoring–such as significant heart failure or severe asthma–would not be well-managed in a telemedicine-only approach.
What are the advantages of using telemedicine for functional medicine care?
Functional medicine, by definition, seeks to find the root cause of health conditions. To do this, we take adequate time to evaluate patients, with most functional medicine consultations being much longer than traditional medical visits. The majority of this assessment is a conversation between the patient and the practitioner, so that naturally works well for video visits.
Additionally, for many people, finding a functional medicine clinician close to their home can be challenging. Having the ability to access a functional medicine provider from home via telemedicine eliminates that issue.
Lastly, many functional medicine practitioners have special skills or training in certain areas, such as hormones, fertility, or Lyme disease. However, that specialized clinician may not be in your neighborhood or even in your state. Being able to access the best practitioner for you leads to the best opportunity for you to get your health back.
What are the disadvantages of using telemedicine for functional medicine?
For some people, not being in the same room as their clinician feels less personal. Additionally, some functional medicine problems are best managed with a physical examination–for example, some neurologic conditions or rheumatologic problems–where the doctor can assess progress through their own in-person physical exam and monitoring of certain vital signs in addition to the patient’s input.
What about a combination of telemedicine and in-person care?
Many patients have a functional medicine clinician that they see via telemedicine and a “boots-on-the-ground” doctor in their local clinic who provides their routine in-person care. This situation can work quite well, especially if the clinicians are open to collaboration. Many patients also use the local health care system to obtain blood draws, get x-rays or other imaging tests, and complete recommended prevention steps, like vaccines and pap smears. At Vytal Health, we routinely interface with doctors in our communities, all with the goal of providing the best care for our patients.